The objective of this project is to develop and test display technology that will aid anesthesiologists in diagnosing and treating unexpected events. Unexpected events occur during 30% of all anesthesia cases. Thirty percent of these events have a significant impact on the patient's perioperative course. Anesthesiologists discover critical events earlier and diagnose the events more accurately when data is presented in a graphic display. Preliminary studies found that when a graphic display of anesthesia breathing circuit faults was used, it reduced event correction time from 45 to 17 seconds. Anesthesiologists who used a cardiovascular graphic display detected myocardial ischemia 1.1 minutes after its onset compared to 3.1 minutes when the display was not used. Errors made in diagnosing shock states decreased by 66% when a graphic display was used. Our research plan is to develop and implement an integrated graphic display of pulmonary and cardiovascular variables. Data-driven visual metaphors will be refined through an iterative design process. Usability testing will guide design enhancements. The resulting display will be implemented in real time to receive and display data from a full-scale patient simulator. The utility of the graphic display will be measured using a realistic patient simulator. Twenty anesthesiologists will be called into a simulated operating room to assist a new resident in managing six unique surgical procedures. Five of the six procedures will have a critical event in progress at the time the clinician enters the room. We will record the time to make the correct diagnosis by analyzing video recordings and data records. Treatment of the event will be scored in comparison to the "gold standard" treatment protocol. We expect to find that the pulmonary and cardiovascular display will be a cognitive aid to the anesthesiologist in diagnosing unusual events more rapidly and more accurately. Phase I results will be analyzed by clinical consultants and the resulting prototype display will move to the Phase II program.